Breech Births

Most babies enter the birthing position a few weeks before birth with their head close to the birth canal. If this does not happen, the baby's butt and/or feet will be positioned for delivery first. This is called " breech presentation."

Breech presentation occurs in about 1 in 25 term babies.

What are the types of presentation in breech presentation?

Complete breech: here the buttocks are directed down, the legs are bent at the knees, and the feet are pressed to the buttocks.
Frank breech: in this position, the baby's bottom is directed towards the birth canal, the legs are extended straight in front of the body, and the feet are pressed against the head.
Footling breech: in this position, one or both of the baby's legs are pointing down and will give birth before the rest of the body.

What causes breech presentation?

The causes of breech presentation are not fully understood.

However, data show that breech presentation is more common:

In subsequent pregnancies
In pregnancies of multiples
When there is a history of premature delivery
When the uterus has too much or too little amniotic fluid
When there is an abnormally shaped uterus or a uterus with abnormal growths, such as fibroids
With women who have placenta previa

How is breech presentation diagnosed?

A few weeks before delivery, the doctor places his hands on the mother's lower abdomen to locate the baby's head, back, and buttocks. If it appears that the baby may be in a presentation, they may use an ultrasound to confirm the position.

Special X-rays may also be used to determine the position of the baby and the size of the pelvis to determine if it is safe to try to have a baby in a vaginal breech presentation.

Could the breech presentation mean that something is wrong?

Although most breech babies are born healthy, the risk of some problems is slightly higher. Birth defects are slightly more common in breech babies, and the defect may be the reason why the baby was unable to assume the correct position for delivery.

Can a breech presentation be changed?

It is best to try to turn the baby between the 32nd and 37th weeks of pregnancy. Methods for transforming a child vary, and the success rate of each method may also be different. It is best to discuss your options with your doctor to see which method he recommends.

Medical methods

External variant: External variant is a non-surgical method of moving the baby in the womb. In this procedure, medication is injected to help relax the uterus. Ultrasound may also be used to determine the position of the baby, the location of the placenta, and the amount of amniotic fluid in the uterus.

Mild pressure on the lower abdomen can cause the baby to roll upside down. Throughout the outer version, the baby's heartbeat will be closely monitored, so that if any problems arise, the doctor will immediately stop the procedure. The external version has a high success rate. However, this procedure becomes more complicated as the due date approaches.

Natural methods

The following risk-free methods, often suggested by physical therapist Penny Simkin, can be tried at home for free:

The breech tilt: Using large, firm pillows, raise your hips 12 inches or 30 cm off the floor for 10 to 15 minutes three times a day. This is best done on an empty stomach when your child is active. In this technique, try to focus on the child without straining the body, especially in the abdomen.
Using music: We know that babies can hear sounds outside of the womb. As a result, many women have used music or recordings of their voice to try and get their baby to move to the sound. Placing headphones on the lower abdomen and playing music or the sounds of your voice can encourage babies to move towards the sounds and come out of the breech position.

Vaginal delivery or cesarean section in breech presentation?

Most doctors do not believe in attempted vaginal delivery in breech presentation. However, some put off making a final decision until the woman is in labor.

The following conditions are considered necessary to attempt vaginal delivery:

The child was born at term and in a clear breech presentation.
The child does not show any signs of anxiety as long as his heart rate is carefully monitored.
The birth process is smooth and stable, the cervix dilates as the baby descends.
The doctor thinks that the baby is not too big or the mother's pelvis is not too narrow for the baby to pass safely through the birth canal.
Anesthesia and caesarean section possible in the shortest possible time

What are the risks and complications of vaginal delivery?

In a breech presentation, the baby's head appears as the last part of his body, making it difficult for him to pass through the birth canal. Sometimes forceps are used to bring the baby's head out of the birth canal. Another potential problem is cord prolapse.

In this situation, the umbilical cord contracts as the baby moves through the birth canal, slowing down the baby's supply of oxygen and blood. During a vaginal birth, electronic fetal monitoring will be used to monitor the baby's heartbeat during labor. A caesarean section may be an option if there are signs that the baby may be in distress.

When is a cesarean section used in breech presentation?

Most doctors recommend a caesarean section for all breech babies, especially premature babies. Because preterm babies are smaller and more fragile, and because a premature baby's head is relatively larger compared to their body, it is unlikely that a baby's cervix will stretch as much as a full-term baby. This means there may be less room for the head to come out.